Seeking Help for an Injury, at Any Price

The New York Times—July 22, 2009

Health reporter Gina Kolata is trained to be an expert skeptic of quick-fix medical miracles: in writing for the Times, she is supposed to take each claim of a cure with a grain of salt until hard research proves otherwise.

Unless, of course, she herself is the one seeking treatment.

Kolata, a runner, was midway through 7 miles on March 12 when she injured her hamstring, resulting in pain bad enough that she could not finish the run. She saw an orthopedist in her hometown who told her to just stretch the muscle. It didn’t help.

Her personal trainer sent her to Joseph Feinberg, MD, at Hospital for Special Surgery in New York. Feinberg said that her hamstring was definitely injured.

“Then he said the magic letters: P.R.P. Doctors at Hospital for Special Surgery, he said, have been trying something new, injecting patients’ own blood or, alternatively, platelet-rich plasma, or P.R.P., directly into the injured area,” Kolata writes.

As a health reporter, Kolata could find no studies formally testing one treatment against the other. And the evidence in support of the treatments is mostly anecdotal, said Ronald Adler, MD, chief of the ultrasound division in the Department of Radiology and Imaging at Hospital for Special Surgery. “The whole issue of why tendons heal is fairly complex and not entirely understood,” he said. “Even surgery, which many consider a gold standard, doesn’t necessarily work.”

But the treatment does have logic in its favor: “The idea of injecting blood or platelet-rich plasma into an injured tendon makes some sense. Blood contains platelets that release growth-promoting molecules that can help tissue heal,” Kolata writes.

“We think a switch gets turned on,” and the body starts to heal the injury, said Brian Halpern, MD, a sports medicine physician at Hospital for Special Surgery. He is the doctor at HSS with the most experience with P.R.P., having used it for two years.

Kolata got the injection at HSS and is waiting to see if that switch gets turned on in her own hamstring. Her doctors are hopeful, especially in light of cases like hers across the country.

“The results over all are so promising and so positive,” said Feinberg.